title: Possible augmentation of neuromuscular blockade by propofol during recovery from rocuronium.
abstract: Propofol is a widely used drug in anesthesia practice, and its pharmacological characteristics are well known. However, propofol is not known for neuromuscular effects. As part of clinical neuromuscular monitoring, the neuromuscular responses to train-of-four (TOF) stimulation were monitored and recorded. We observed, in two cases of balanced anesthesia maintained by desflurane and fentanyl, that administration of a small dose of propofol during almost complete recovery from rocuronium in two patients resulted in marked decreases of both T1 (first twitch response of the TOF) and the TOF ratio. This neuromuscular block dissipated in both patients without any subsequent neuromuscular effects. These two observations provide visual confirmation of the possible impact of propofol on recovery from a rocuronium neuromuscular blockade.
authors.affiliation: Department of Anesthesia and Perioperative Care, University of California San Francisco, 521 Parnassus Avenue, Box 0648, San Francisco, CA 94143, USA. heiner.ruschulte@mac.com
authors.forename: Heiner
authors.initials: H
authors.lastname: Ruschulte
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Ward
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Miller
authors.forename: Matthias R
authors.initials: MR
authors.lastname: Braehler
mesh_terms: D000759:Adjuvants, Anesthesia; D000328:Adult; D000732:Androstanols / Q000037:antagonists & inhibitors; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D004347:Drug Interactions; D004558:Electric Stimulation; D005260:Female; D005626:Frontal Sinus / Q000601:surgery; D006801:Humans; D008338:Mandibular Injuries / Q000601:surgery; D008874:Midazolam; D016343:Monitoring, Intraoperative; D009388:Neostigmine / Q000627:therapeutic use; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000037:antagonists & inhibitors; D011127:Polyps / Q000601:surgery; D015742:Propofol; D012121:Respiration, Artificial; D000077123:Rocuronium; D055815:Young Adult
chemical_list: D000759:Adjuvants, Anesthesia; D000732:Androstanols; D018686:Anesthetics, Intravenous; D002800:Cholinesterase Inhibitors; D003473:Neuromuscular Nondepolarizing Agents; D009388:Neostigmine; D008874:Midazolam; D000077123:Rocuronium; D015742:Propofol